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Class-Action Lawsuit Against Insurance Company, United Healthcare

United Healthcare had a policy of denying Proton beam radiation therapy to prostate cancer patients, now a class-action lawsuit is being filed.

It took a personal injury attorney that needed treatment for prostate cancer to open Pandora’s box and expose all of the past life-saving treatments that had been denied by United Healthcare.

The personal injury attorney ended up paying over $85,000 from his own pocket in order to attain the cancer treatment.

Though the attorney had the financial means to pay for his treatment, he filed the class-action lawsuit on behalf of the thousands of other people that are not as fortunate to have the ability to pay for this life-saving treatment and were denied coverage.

Even the judge assigned to hear the case, U.S. District Judge Robert N. Scola Jr., recused himself because of his own past experience of being denied coverage by United Healthcare for his own prostate cancer treatment. He said he could not be “impartial” while hearing the case.

He even cited a personal friend of his that was also denied coverage for the proton beam radiation therapy to treat his prostate cancer. The judge’s friend had to cough up over $150,000 in order to attain the cancer treatment. (The case has now been assigned to a different court).

United Healthcare would deny coverage saying that proton beam radiation therapy was an “experimental” method of treatment. Though it has been considered an accepted method of cancer treatment since the 1980s.

The judge went on to criticize United Healthcare for denying patients health care.

“It is undisputed among legitimate medical experts that proton radiation therapy is not experimental and causes much less collateral damage than traditional radiation,” Scola wrote. “To deny a patient this treatment, if it is available, is immoral and barbaric.”

The attorney/patient that filed the class-action lawsuit noticed that his own health insurance provider seemed focused only on making money rather than providing proper and adequate care.

He said he believed the insurance company did not view his situation as, “what are the best options for treatment”  but instead just flat out told him they do not pay for that treatment what so ever.

United Healthcare

Shortly after the coverage for his treatment was denied and after multiple attempts to get reimbursed for his medical expenses, United Healthcare acknowledged proton beam radiation actually is a proven cancer treatment method and revised its approval policy for it.

Isn’t that proof that the previous policy was not in the best interests of patients?  Shouldn’t there be justice for the people that were denied this life-saving treatment prior to the insurance company’s faulty policy being exposed?

According to the lawsuit, United Healthcare violated the Employee Retirement Income Security Act, which sets minimum standards for private insurance protections.

The lawsuit is asking that United Healthcare go back over all prior insurance claims for proton beam radiation therapy and reprocess those claims under the newly updated policy.

It is also requesting those past patients that were denied treatment also be reimbursed for their unpaid benefits with interest.

Thousands of past patients may be eligible for the class-action lawsuit.

It is important to have people treated properly by their health insurer. Lawsuits are the only message the insurance companies seem to hear that force them to change their policies to fit the best interests of their patients.

After all, when we get sick and need medical care, are we patients or are we customers?

Read Judge Scola’s order below:

https://medcitynews.com/uploads/2019/04/Order-of-Recusal.pdf

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